Moving towards digital care

Hello everyone. My name is Amy, and I am here with Hayley. Thank you so much for having us. Today, we will be talking about the movement towards digital healthcare that we are seeing currently. To give a quick overview of what we will be covering: we will discuss what we mean by digital healthcare, some of the pros and cons of using digital technology in healthcare, examples of where it is currently being used, and some future uses and research.

When I typed 'digital healthcare' into a search engine to set up this webinar, the image I got looked very futuristic and 'matrix-y'. This is the complete opposite of what I see as digital healthcare technology. Digital health technology should be about moving the power of controlling health back to the patient and the service user. We shouldn't be focusing on the 'techie' medical bits; it is all about how people can use technologies to support their health and well-being.

In a nutshell, digital healthcare is anything electronic or digital in nature that we can utilize to improve health and well-being for either the individual or at a population level. Many of these tools and technologies are already in everyday use, such as smartwatches, smartphones, social media, video calls, telehealthcare, and online support groups. There are also less common tools, such as wearable sensors, virtual reality, and augmented reality.

There are many pros to using digital technology in health. It can often be used anytime and anywhere, which makes it much more usable for patients. We are not confined to the times when healthcare professionals are available or services are open. It also reduces travel needs, which is beneficial for the environment and increases the accessibility of services for people who live rurally or lack transport. It is often cheaper, as it is healthcare staff, not technology, that is expensive. It also has the potential to reach more people than one-on-one face-to-face care and reduces bias. For example, using artificial intelligence in diagnostics can reduce the unconscious biases humans might have regarding pain medication prescriptions for different demographics.

However, there are areas of concern. Technology can be challenging to use due to user-friendliness or a lack of digital literacy—this applies to both patients and staff. There are concerns about privacy and information security regarding who has access to health records and who is monitoring patient data. People also worry about AI and robotics replacing human contact, though, in reality, these technologies often increase human interaction where it is most needed. Finally, there are questions around the accuracy and efficacy of these tools compared to face-to-face interventions.

Digital tech is used everywhere in all aspects of health. The 'health triangle' reminds us that health is not just physical; it includes mental, emotional, and social well-being. When looking at chronic conditions like brain injury, digital healthcare can support all these areas.

Regarding examples: wearable sensors like smartwatches and Fitbits can help monitor activity levels or help patients pace themselves after a period of inactivity. Eye-tracking and eyeglass technology have potential for object and facial recognition if there is brain damage in areas controlling those functions. Body sensors are already used in diabetes care to send consistent readings to a phone or remote practitioner. Smart clothing can measure vital signs or assist with wayfinding for those struggling with memory issues, potentially using haptics to help people find their way. Even simple tracker technology can help locate lost items.

Smartphone tools and apps are highly accessible. Many have built-in reminders, planners, and diaries that help with scheduling activities or managing fatigue. There are also specialist apps for diet, meditation, medication, and sleep. A caveat is that there is not much regulation regarding the efficacy of these health apps. Voice-activated devices like Alexa and Siri are also helpful for health reminders or assisting those with limited mobility.

Telehealth has become very familiar since Covid-19, allowing for online appointments and digital health records that can be passed between services instantly, speeding up diagnostics. Digital wards allow for remote monitoring by nurse practitioners. Communication tools like video calls and social networks are crucial for social health when physical contact is limited. Physical technologies, such as friendship lamps that light up when a friend turns theirs on, or digital photo frames, help reduce isolation.

Digital interventions also include text messaging for appointment reminders, which has significantly reduced missed appointments, and support for addiction or smoking cessation. AI can potentially be used at the start of a diagnostic process to determine the best therapy for an individual. Gamification, like using fitness games for physical therapy, helps people practice using limbs and rebuild muscle strength. Online peer support is also valuable for providing access where local services do not exist and offering anonymity for sensitive topics.

I will now pass you over to Hayley to talk about our current project.

Thank you, Amy. I want to give an example of a digital intervention in action. For the last couple of years, we have been working on providing digital support for mental and sexual well-being after brain injury. This has been developed with and for people living with brain injury, so it is very person-centered. We spent months working with people to find out what emotional and social needs they have that might not be covered in typical rehabilitation programs. We are currently testing this intervention and will soon be opening it into a trial.

In the trial phase, we are testing a self-directed version versus a peer-supported version. As Amy mentioned, people might not feel comfortable in peer environments when the topic is sensitive, and mental and sexual well-being are very personal. We are excited to see which approach people prefer. Our program is based on positive psychology, focusing on positives rather than just the negative aspects of injury, creating a 'spiral of positivity'. This is just one example of how we can take traditional approaches of self-management and peer support and put them into a digital intervention to make them more accessible.